Scleral lenses · Concord Eyecare, North Strathfield

Scleral Lenses Sydney

A large rigid lens that vaults right over your cornea and holds a layer of fluid against it all day. Two very different groups of people end up here — and the honest answer is different for each.

“I’ve tried everything for my dry eye”Drops, ointments, plugs — and your eyes still burn by lunchtime. Sometimes with Sjögren’s or another diagnosis behind it. Whether sclerals help depends on which kind of dry eye you have.

“Glasses can’t fix my vision any more”Keratoconus or another irregular cornea, where the shape itself is the problem and no spectacle lens keeps up.

$2,200

both eyes — lenses, fitting and two years of reviews

Measured, not guessed

we scan the space under the lens rather than judging it by eye

Made to your eye

custom made in Australia, not picked off a shelf

Find out if sclerals can help my eyes Or call (02) 8765 9600

Reviewed by Dr Mark Joung, B.Optom (Hons) UNSW · Last updated August 2026

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Therapeutically Endorsed
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Years Clinical Practice
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Scleral lenses for dry eye

Tried everything and still burning? It depends which kind of dry eye you have.

Scleral lenses are a real fix for one specific kind of dry eye: the severe, aqueous-deficient kind, where the eye simply cannot make enough tears. For the far more common evaporative type, they are usually not the answer. Working out which one you have is the whole game — and it is where we start.

Where sclerals help

Aqueous-deficient and severe dry eye

Sjögren’s syndrome, graft-versus-host disease, Stevens-Johnson syndrome, and other conditions where tear production has genuinely failed — your eyes are not making enough tears, rather than losing them too fast.

The lens holds preservative-free saline against the cornea all day — it does the hydrating your own tears cannot. This is where the evidence is strongest: in people with severe disease, symptom scores roughly halved, from about 68 to about 35 in one prospective trial.

Where they’re usually not the answer

Evaporative dry eye and MGD

The common type — meibomian glands that are blocked or sluggish, so the tears you do make evaporate too fast.

Sclerals do not fix the glands, and there is little evidence they help this group. The tool that treats the cause is IPL plus lid therapy. We will steer you there first rather than sell you a lens that works around your problem.

How we do it at Concord Eyecare

So we don’t jump to sclerals

Diagnosis→ IPL→ Drops + omega-3→ Scleral lenses

We start with diagnosis — meibography with our Meibovue device, which photographs the oil glands in your eyelids, and tear-film measurement with the Medmont E300 — and then work through treatments in order of how involved they are.

To be clear, this is our own order of preference, not an official guideline. No consensus report sets a fixed sequence, and there are practices that would go to a scleral lens sooner than we would. We work this way because treating the cause is usually simpler, cheaper and longer-lasting for you than working around it — and because we would rather not fit you a lens you turn out not to need.

For Sjögren’s the combination works well: IPL addresses any gland component while sclerals compensate for the aqueous deficiency IPL cannot fix. Co-managed with your rheumatologist.

What the evidence actually says — and doesn’t

The 2025 international dry eye consensus report (TFOS DEWS III) places scleral lenses under tear conservation — keeping the eye’s own moisture on the surface — alongside punctal plugs and moisture-retaining glasses.

Notably it does not rank those options in an order — which is why the sequence above is ours rather than anyone’s official recommendation. The same report says plainly that robust studies supporting scleral lenses for dry eye are lacking — most of what is known comes from small case series, and the symptom-score halving above is one of them. We would rather you knew that before you decide. If you have been offered a lot of confident promises about dry eye over the years, that is exactly why.

Scleral lenses for keratoconus and irregular corneas

When the shape is the problem, the lens becomes your new front surface.

When the cornea is distorted, no soft lens gives reliable clear vision — it simply follows the irregular surface underneath. A scleral vaults completely over the cornea, and the fluid trapped beneath it becomes a new, smooth optical surface. The distortion is neutralised rather than corrected around.

6/19 → 6/7.5

Average vision in glasses, then in scleral lenses — from a keratoconus series of 157 eyes. In a separate study of 112 eyes with irregular corneas, vision improved by around five lines on the chart. Both figures are measured against spectacles, not against other contact lenses. Results vary between individuals.

This also covers pellucid marginal degeneration, corneas that have had a graft, and irregularity left behind by earlier surgery. Unlike ortho-K, which reshapes a regular cornea overnight and is removed during the day, a scleral vaults over an irregular one and is worn while you are awake. Different tools, different problems.

What a scleral lens does

Gives you back sharp vision

Often the best you have had in years, and it can do it on the day the lenses go on.

What it does not do

Stop the cone changing

In 157 eyes followed at least a year, about 15% lost some of their best lens-corrected vision as the keratoconus progressed underneath a well-fitting lens. Corneal cross-linking is the treatment aimed at progression, and we refer for it.

Keratoconus — the condition, and all of your options What keratoconus is, what happens if it goes unchecked, how progression is monitored, and every treatment on the ladder including cross-linking, rings and grafting. Read that first if you have just been diagnosed.

What are scleral lenses

Why it can work when nothing else has.

Every other lens depends on the surface of your eye being good enough to work with — which is exactly what your eye may not have. A scleral lens skips that surface entirely: it arches right over the cornea and rests on the white of the eye, which has far fewer nerve endings, and the space underneath is filled with preservative-free saline before the lens goes in.

The lens brings its own tear film. That single fact is why sclerals do two jobs at once. The fluid layer gives a perfectly smooth optical surface regardless of the shape underneath, and it keeps the cornea bathed all day. A soft lens can do neither — it takes the shape of what it sits on, and it relies on the tears you already have.

So what does that mean when you are choosing? The table is the short version — the right-hand column is the reason each row matters.

	Scleral lens	Soft lens	Corneal rigid lens	Why it matters to you
Rests on	The white of the eye	The cornea	The cornea	Landing off the cornea is why a scleral can be worn on an eye that rejects other lenses
Fluid underneath	Yes — a saline reservoir	No	No	The reservoir is what treats a dry surface as well as correcting vision
Irregular cornea	Vaults over it	Drapes over it	Sits on it	Only vaulting fully neutralises the distortion
Comfort at insertion	Learning curve	Immediate	Adaptation needed	Sclerals take practice to handle, then are usually the most comfortable rigid option
Replacement	About 2 years	Daily to monthly	1–2 years	A longer life offsets the higher upfront cost

One thing worth clearing up: these are medical scleral lenses, prescribed and custom-fitted to your eye. They are not the cosmetic “sclera” lenses sold online for costume use, which cover the white of the eye for appearance and are a genuinely bad idea to wear unfitted.

Ready to find out if sclerals are right for you?

No referral needed. Appointments Monday to Saturday.

Book a Scleral Lens Assessment Call (02) 8765 9600

What to expect from scleral lenses

More comfortable than smaller rigid lenses. Not effortless.

Most people find scleral lenses more comfortable than smaller rigid lenses, and the vision is usually excellent from early on. What they are not is a lens you forget about entirely — insertion takes practice, and a proportion of wearers get midday fogging. Here is the honest version of all four.

Vision

Usually excellent. The saline reservoir gives a smooth optical surface regardless of the shape underneath, so the improvement can be dramatic on an irregular cornea. What sclerals do not do is stop keratoconus progressing — cross-linking is aimed at that, and the two work together.

Comfort

In a survey of over 400 people with keratoconus, comfort scored 3.3 out of 5 for scleral lenses against 2.2 for corneal rigid lenses.

More comfortable is not the same as perfect: two thirds of wearers in that survey still reported some discomfort. You will be aware of the lens. It should not hurt.

Insertion and removal

Takes practice, and this is the part people underestimate — most get confident within one to two weeks. We teach you on fitting day and keep going until you can manage alone, as often as you need, at no charge.

Midday fogging

Somewhere between a quarter and a half of wearers get clouding partway through the day, as debris builds up in the fluid layer.

The fix takes a few minutes: out, rinse, refill with fresh saline, back in. Manageable — and worth knowing before you start rather than after.

One more honest note. Against corneal rigid lenses, a randomised trial found sclerals significantly more comfortable but measured no advantage in vision, and preference split almost evenly. So if you already wear a smaller rigid lens happily, there is no vision reason to switch. If you are taking it out by mid-afternoon, that is the reason — and it is a good one.

How we fit scleral lenses

A program, not a single appointment.

Scleral lens fitting at Concord Eyecare runs as a program: assessment, fitting day, a recheck later the same day, then reviews at one week, one month and three months, and six-monthly after that. We use the leading scleral lens manufacturers, who offer fully custom designs — your lens is made for your eye, not adapted from a stock shape — and we fit it using a scan that measures how much room there is between the lens and your eye.

1

Appointment 1 · about an hour

Assessment and mapping

A full examination, then detailed mapping of your cornea and the white of your eye, so the lens is designed to your eye’s actual shape rather than adapted from a standard one. A trial lens from our diagnostic fitting set lets us check the fit and your prescription on the day.

2

~2 weeks later · 60 to 90 minutes

Fitting day

Your custom-made lenses arrive from the lab. We put them on, confirm with the scan that they sit exactly as designed, and start teaching you insertion and removal.

3

Same day · 30 minutes

Recheck

You come back later the same day, lenses still in. A scleral settles over the first hours of wear, so we measure the fit as it ends up rather than how it looked at insertion. Handling training carries on until you are confident — come back as often as you need, no charge.

4

1 week · 1 month · 3 months

Reviews — all included

Comfort, vision, fit and the health of your eye’s surface, plus any handling or fogging niggles. All included in the one fee.

5

Ongoing

Six-monthly reviews

Regular monitoring to keep the fit right and your eye healthy — more often if your condition is advanced or changing. Lenses typically last about two years before replacement.

Why we scan rather than judge by eye

A scleral has to arch over your cornea with a layer of fluid underneath — not touching it, and not sitting too far off it either. We measure that space with a scan rather than estimating it down the microscope. In a study of 66 contact lens practitioners, estimating it by eye overshot the scan by roughly the thickness of a sheet of paper — and experienced fitters were no more accurate than newer ones. The whole range that works is only about two sheets thick, so measuring rather than guessing is the difference between a lens that fits and one that needs changing.

How much do scleral lenses cost in Australia

One price to start. Less to keep going.

Scleral lenses at Concord Eyecare cost $2,200 for both eyes. That covers the assessment, all scans, the lens design, both lenses, every fitting appointment, a six-month window to get the fit right, and two years of reviews. Lenses last about two years; after that you need new ones, and that is the $1,400 cycle.

To start

$2,200

Both eyes — the lenses and the whole fitting program

The assessment and all scans

Both lenses, custom made for your eyes in Australia

Every fitting appointment, and two years of reviews

Handling training, for as long as you need it

A three-month starter solution supply

Six months to get the fit right — changes and breakage

Then, when lenses are due

$1,400

Per two-year cycle, once your first lenses need replacing

A fresh pair of lenses

The assessment that goes with them

All reviews across those two years

The first payment carries the fitting work — the scans, the design, and the appointments it takes to get a lens sitting right on your eye. That work is done once, which is why keeping the lenses going costs less than starting them.

The first six months — getting the fit right

For six months from collection, any change to the lens design or power needed to get the fit right is at no cost, and so is breakage. That is the settling period, when changes are most likely, and it is the window we guarantee.

After that, and after two years

Beyond six months, if your prescription changes or a lens needs replacing, we will quote it before ordering anything. Lenses last about two years in normal wear — when yours are due, that is the $1,400 cycle above.

Health funds

Scleral lenses come out of your ordinary optical extras limit. There is no separate benefit for medically necessary contact lenses, so for most funds that is a few hundred dollars a year. We will give you an itemised receipt to claim against.

Ongoing costs

Solutions are similar to any rigid lens care routine. We will walk you through the full picture at your assessment, before you commit to anything.

Some eyes need more than the standard program — a cornea irregular enough to need a lens designed from a detailed surface scan, a lens fitted after a corneal graft, multifocal optics, or a specialised surface coating. If yours is one of them we will tell you in writing and before we order anything. You will never receive a bill you have not already agreed to.

Find out if sclerals can help my eyes

Are scleral lenses right for you

We’ll tell you straight — including when the answer is not yet.

We assess every eye individually and give you a straight answer about whether a scleral lens is the right move. Sometimes it is not — and the most common reason is that something simpler has not been tried properly yet. We would rather say that than fit a lens that works around your problem instead of treating it.

If your dry eye is the evaporative kind, we will say so.

That is the common type, and sclerals do not fix the blocked glands causing it. IPL and lid therapy treat the cause — a cheaper, less involved path, and the one we would try first.

If you are already in a comfortable rigid lens, we will say that too.

Against smaller corneal rigid lenses the measured advantage of a scleral is comfort, not vision. If yours is comfortable and you wear it all day, changing costs money and gains nothing.

And handling has to be workable for you.

A scleral is a bigger lens that needs filling with saline before it goes in. Most people manage within a week or two and we keep teaching until you do — but if handling genuinely will not work, better to find that out at the assessment than after the lenses are made.

Conditions we look at carefully first

None of these rules a scleral lens out. They are the things we examine properly before fitting, and where we may want an ophthalmologist’s view alongside ours.

Which conditions, and why

Glaucoma — particularly where there is a drainage device or a filtering bleb, since a scleral lens rests on that part of the eye.

Fuchs’ endothelial dystrophy — the cornea’s inner pump layer is already working hard, and we want to know how much reserve it has.

Active infection or inflammation — treated and settled before any lens goes on.

A history of herpetic keratitis — assessed individually, because lens wear can be a trigger for recurrence.

Frequently asked questions

Scleral lenses — what patients ask us.

How much do scleral lenses cost in Australia?

At Concord Eyecare the program is $2,200 for both eyes — assessment, scans, both lenses, every fitting appointment, a starter solution supply, six months to get the fit right at no cost, and two years of reviews. Lenses last about two years; a new two-year cycle is then $1,400 including the replacement lenses. They come out of your ordinary optical extras limit; there is no separate health-fund benefit for medically necessary lenses.

What are the downsides of scleral lenses?

Three, honestly. Insertion and removal take practice — most people are confident within one to two weeks, but it is a real learning curve. Between a quarter and a half of wearers get midday fogging that needs the lens rinsed and refilled. And they cost more upfront than soft lenses. They also do not treat everything: for evaporative dry eye, the common type, they are usually not the right answer.

Are scleral contacts covered by Medicare?

The lenses are not covered by Medicare. Private funds treat them as ordinary optical extras rather than a separate medically-necessary category, so what you claim comes out of your usual annual optical limit — for most funds, a few hundred dollars. We will give you an itemised receipt.

Can you get 20/20 vision with scleral lenses?

Many people do, and for an irregular cornea the improvement over glasses can be dramatic — in one keratoconus series average vision went from about 6/19 in glasses to about 6/7.5 in scleral lenses, measured against spectacles. What nobody can promise is a specific result for your eye: that depends on how irregular your cornea is and whether there is scarring, which is what the assessment is for.

How long do scleral lenses last?

About two years in normal wear. We check the condition of the lens at your reviews and tell you when yours is getting close, rather than leaving you to notice. A replacement two-year cycle is $1,400 for the pair.

Can you sleep in scleral lenses?

No — scleral lenses are for daytime wear and come out before you sleep. The fluid layer cannot refresh overnight, and closed-eye wear raises the risk to the cornea. If overnight wear is what you want, that is ortho-K — a different treatment for a different problem, and not for irregular corneas.

Can scleral lenses help with dry eye?

For severe aqueous-deficient dry eye — where your eyes cannot make enough tears, as in Sjögren’s syndrome — yes. The lens holds preservative-free saline against the cornea all day, and symptom scores roughly halved in one prospective trial. For the far more common evaporative type we treat the cause first with IPL. The 2025 consensus report also states plainly that robust studies for sclerals in dry eye are lacking.

Book a scleral lens assessment

Find out whether a scleral lens is your answer — or whether something simpler is.

One assessment tells us which kind of problem you actually have, and we will give you a straight answer either way. If the honest answer is that something else should be tried first, that is what we will say.